Individual
JACOB KEVIN MCDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1601 LAWRENCE DR STE 100, DE PERE, WI 54115-3931
(920) 426-4700
Mailing address
PO BOX 19070, GREEN BAY, WI 54307-9070
(920) 496-4700
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
13393-24
WI
Other
Enumeration date
05/31/2016
Last updated
09/28/2022
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